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My doctor was notified by the hospital he was contracted with that his services are no longer necessary.

He was also the person who oversaw the nursing home program, and it wasn't making money, so they cut that program. Because they cut that program, they decided he was not needed, either.

That also will bring to an end the HIV program, which he also oversaw. He is also the only doctor contracted with the state's Ryan White Program in this region.

So, we are scrambling to find a way to keep him practicing, at least for the HI-Fivers.

If we can't figure out some solution, we will have to go to Plan B - except there is no Plan B a this time.

I got a call from one of the doctors who oversees the Ryan White Program who asked me to come up with some sort of solution in case the doctor we now have is forced into retirement, even thought he doesn't want to retire.

There are two other clinics where people can be seen. One is in the town of Gallup, a four-hour round trip. The other is in Albuquerque, which is a six-hour round trip.

Neither of these are viable options because many of the people I know don't have reliable transportation, at least not reliable enough to make the trek to Albuquerque, the most likely choice.

I used to have to do this, back in the early 90s when there were no doctors here who saw HIV patients. It was a royal pain in the ass.

It was bad enough the doctor still had me on a quarterly visit schedule. But trying to coordinate getting lab work done, driving three hours to get to an appointment on time, then driving three hours home again, was no fun. It also meant taking a full day off of work and, in the winter, snowstorms could either slow you way down or force you to cancel appointments.

Nope, not a good option.

The clinic in Gallup is not a good option because it is already overloaded. It handles all kinds of patients, not just HIV. I have driven people to their appointments. It is not uncommon for you to be there three to four hours, most of that time waiting.

Not a really good option either.

Those living here who could be seen by the Indian Health Service could access care there. But, that doctor is leaving in May and nobody is really sure who will take over. Also, those patients spend more time dealing with pharmacists, who act as intermediaries. They only see the doctor sporadically. I don't like their system much.

Another possibility would be to see the HIV doctor in Durango, Colo. But this only would work with those who have private insurance, or Medicare with a private Part D plan. Even then, the insurance company would probably have to approve this move because Durango, while only 30 miles from my home, is in another state.

Those who are insured under the New Mexico Medical Insurance Pool, or who get their meds from the state's Department of Health Pharmacy, who are the majority in this area, could not access care in another state, no matter how close.

Frankly, I am at a loss at this point. If the current doctor isn't allowed to continue to practice, I guess we will have to start visiting doctors to see who would be willing to fill the gap. But they would have to be wiling to contract with the Ryan White Program, which, I understand, is a lot of paperwork.

What else is new.

Oh, did I mention this is to take place June 30th? That gives us less than three months to find a solution - or not.

My first thought is that there is hope because you are there advocating for them as well as yourself ... that pretty much my second thought too . Its sounds like a tough situation and one that should not be allowed to exist in this country .

What is the possibility of the current doctor joining with another local doctor as to continue providing services? I just couldn't imagine going back to having to travel several hours for adequate care. That all sounds so 80's and shouldn't be happening these days.

I cannot even imagine the frustration you're feeling. And while you are advocating for yourself and your clients, just having one person do this is exhausting.

I understand, a tiny bit, of how you're feeling. We only have 3 doctors in this area, with an influx of people getting testing and new diagnosis ongoing, so it takes a while to get someone into a doctor, then they usually spend 15-20 minutes per patient. My doctor had 3 doctors join him to take the load off of his "non"-HIV patients, but he seems to be seeing more (people w/o HIV). One of my clients just had to have a tumor taken out just above his knee, and the nearest place that would do this surgery was Chicago! Quite a drive indeed, though only an hour and 1/2.

Good luck with this, Mark. I feel for you.

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I've never killed anyone, but I frequently get satisfaction reading the obituary notices.-Clarence Darrow

How far is the closest medical school? We have an Infectious Disease doc that comes out to our local clinic a couple of times a month from Beth Israel Deaconess in Boston, part of the Harvard Med Sch system, and that is over 2 hours away. We have other specialist that come out to the clinic also, but not as often. Of course, it helps that we are a resort town & some of them have vacation haunts here & work here on a Friday or Monday so they don't have to fight the weekend traffic.

What a stupid problem for any half way prosperous country to be having. Is my first reaction, your commitment is plain, Mark , hats off to you. Help me, who politically is responsible for health care provision in your state? What about other conditions how do they get treated.

I suppose I want others to join you , as your post Mark , paints such a huge dollop off responsibility on you , how about a group off people working to gether on what is after all something that is already set up and running.

Good luck and all the strength possable to you, Mark

M

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"If we can find the money to kill people, we can find the money to help people ." Tony Benn

How many patients are affected by this? If all of you would caravan to the Board of Supervisors meetings for the next three months, every citizen is entitled to address the board for 3 minutes each, on topic of their own choice. I have done this in Los Angeles and in Lakeport, you will get support from the Board. County Counsel will be present and may offer help too.

You are a writer, why not write a series of letters to state officials asking for their support, post them in the Activism thread so Forum members can print them out and mail them in from around the world. Send press releases to the local papers and Letters To The Editor and you will build a grass roots support community demanding HIV care for all. The domain name commissiononaids.org worked for me, domain name is ready and available. It is a lot of work, you will need volunteers but you can do it. Have the best day Michael

When I learned of the doctor's dismissal, I started making phone calls and sending emails to various and sundry people at the state level.

Turns out I was not alone. Apparently, since this doctor also coordinates care among all the area nursing homes and the hospital, there are quite a few others out there who are unhappy with this situation.

Apparently, someone, who shall forever remain nameless, leaked the date and time of the hospital board meeting this month. The turnout was exemplary, including quite a few from the medical community who were unhappy about this.

The net result is things are looking more hopeful now, although I have not heard the final verdict as yet.